Kornimate/medical-research-clean huggingface dataset:
adherence to universal aspirin compared to screening indicated aspirin for prevention of preeclampsia

Conditions: Medication Adherence; Preeclampsia

Summary: there are data showing that a majority of pregnant women may not be accurately identified as high risk through screening and therefore, not receiving prophylactic low dose aspirin as recommended. this leads to missing many patients who would benefit from aspirin administration. aspirin is an effective, affordable and safe intervention and its universal use in pregnancy has been proposed as the answer to help mitigate risk of significant morbidity from preeclampsia. however, adherence to aspirin in women at low risk compared to those deemed at high risk of preeclampsia has never been studied. one of the arguments against universal aspirin administration is the concern that universal receipt would change the compliance in those at high risk although there are no data to support this concern. to address the lack of data on differences in adherence, our goal in this proposal is to assess whether there is a difference in adherence to low dose aspirin (81 mg) in women at high risk of preeclampsia as indicated by uspstf risk algorithm when compared to those women randomized to universal use.

research objective- to compare adherence to low dose, 81mg of aspirin in women considered high risk by uspstf criteria vs universal receipt. hypothesis: women considered high risk by uspstf criteria will have better adherence to low dose aspirin than women randomized to universal receipt. study design: randomized trial population: english or spanish speaking women between 10-20 weeks of gestation receiving their care at women \& infants hospital, with a plan to deliver at women \& infants hospital once enrolled, patients will then be randomized to uspstf criteria to determine if they qualify for aspirin or to universal aspirin receipt. once randomized, patients will undergo video pill counts at multiple intervals in their prenatal care (monthly).

Eligibility criteria:
inclusion criteria: * pregnancy between 10 to 20 weeks gestation by best available dating * 18 years of age or older * fluency in english or spanish exclusion criteria: • contraindication to aspirin use

Keywords: aspirin preeclampsia adherence pregnancy
use of real-time fluorescence imaging in diabetic foot ulcers: the impact of colonization

Conditions: Infection, Surgical Site

Summary: the study evaluates the efficacy of fluorescence-guided de-colonization in patients with non-infected diabetic foot ulcers. the efficacy will also be compared between those who used artificial dermis and split-thickness skin graft for reconstruction surgery.

diabetic foot ulcers (dfu) are the main cause of hospitalization in diabetic patients. these hard-to-heal ulcers have a high amputation rate, and a 5-year mortality rate of 50% once being amputated. treatments for dfu include infection management, wound debridement, revascularization, pressure off-loading, etc. recently, a novel imaging device called moleculight i:x was introduced to help visualize clinically undetectable fluorescent bacteria in wounds and has shown promising effects in the identification of infection. however, as microorganisms almost colonize all chronic wounds, the term "bacterial colonization" should be distinguished from clinical infection. while infection delays the healing process, the impact of colonization on wound reconstruction remains unclear; and the assessment is often more difficult on dfu patients with peripheral neuropathy and vascular diseases. in the present study, investigators will conduct a prospective randomized controlled trial to evaluate the clinical outcome of achieving "high-quality de-colonization" with the aid of moleculight i:x in the treatment of noninfected dfu patients, and to compare its efficacy between artificial dermis and split-thickness skin graft.

Eligibility criteria:
inclusion criteria: 1. 20 ≤ age \< 80 2. body mass index (bmi) \< 35 kg/m2 3. glycated hemoglobin (hba1c) \< 10% 4. target ulcer: (1) 10 ≤ size \ 3 cm between target ulcer and other ulcers 5. transcutaneous oxygen pressure (tcpo2) ≥ 30 mmhg and 0.8 ≤ ankle-brachial index (abi) ≤ 1.2 6. patient willingness and signed informed consent exclusion criteria: 1. pregnancy 2. type i diabetes mellitus (type i dm) 3. active malignancy 4. taking glucocorticoids, immunosuppressants, or in an immunocompromised status 5. lab test upon admission for reconstruction surgery: (1) hemoglobin (hb) \ 3x upper normal limits (3) albumin \< 2.5 g/dl

Keywords: diabetic foot ulcer non-infected autofluorescence fluorescence imaging moleculight artificial dermis split thickness skin graft
improving diabetes care via telephone assessment and patient education

Conditions: Diabetes

Summary: the purpose of this study is to improve the quality of va diabetes care using an automated telephone disease management (atdm) system that administers patient assessments and targeted self-care education between clinic visits.

background: the purpose of this study is to improve the quality of va diabetes care using an automated telephone disease management (atdm) system that administers patient assessments and targeted self-care education between clinic visits. objectives: in this ongoing study, we are determining: 1) the reliability and validity of automated telephone disease management (atdm) assessments of patients' glycemic control, health-related quality of life (hrql), self-care, and satisfaction with care; 2) the extent to which these assessments identify patients at risk for poor outcomes; and 3) the cost-effectiveness of an intervention in which atdm assessment reports are provided regularly to patients' primary care providers. methods: we are refining and expanding previously-developed atdm assessment instruments by incorporating measures of patient-centered outcomes. we are enrolling 450 patients from visn 12 and visn 21. patients receive weekly atdm assessments for six months. other data on their health status and service use are being collected from medical records, laboratory tests, telephone surveys, and austin automation center files. after determining the concurrent reliability, validity, and prognostic significance of the atdm assessments, we will examine variation in atdm-reported outcomes across networks, facilities, and patient groups. in the second phase of the study, we will conduct an effectiveness trial with a one year follow up period. we will use the findings from our process evaluation to modify the atdm assessments and design provider feedback reports. we will enroll 240 patients from the two networks (i.e., 480 patients overall). patients will be assigned to experimental or usual care control groups using a combination of randomization and cutoff-based assignment. we will measure the intervention's impact on patients' glycemic control, symptoms, self-care, and patient-centered outcomes. we will use va costing database and medicare claims files to evaluate cost-effectiveness. status: analyses of atdm assessment data suggest that this method is feasible with va diabetes patients and provides comparable data regarding patients' satisfaction with care and functioning to telephone surveys. other analysis suggest that va interpersonal processes of care and rates of cost-related medication adherence problems are as good or better than that experienced by patients with comparable characteristics treated in other systems of care.

Eligibility criteria:
inclusion criteria: patients enrolled in visn 12 and visn 21 exclusion criteria:
cell therapy for venous leg ulcers pilot study

Conditions: Venous Ulcer

Summary: chronic venous leg ulcers (cvu) represent a medical problem associated with significant morbidity, increased work absenteeism and earlier retirement as a consequence of disability. this strongly affects the patient's quality of life and has a significant economic impact on healthcare systems. reports of studies with animal models show that treatment with bone marrow-derived stem cells has a beneficial effect in healing chronic skin wounds. the purpose of this pilot study is to determine the safety and feasibility of cell therapy with bone marrow derived cells (bmdc) as a complementary healing therapy in chronic venous leg ulcers, and in addition to evaluate its effectiveness. the knowledge gained in the pilot study will be used to refine the clinical protocol procedures of a subsequent randomized study. patients with venous legs ulcers meeting eligibility criteria and providing appropriate written informed consent will be enrolled for study participation. enrolled patients will receive autologous bmdc implantation at de venous ulcer in conjunction with standard of care (soc) treatment. during follow up, adverse events will be assessed by ulcer clinical examination. effectiveness of the experimental treatment will be assessed by evaluating ulcer healing (reduction of the ulcer area) and pain reduction over a six-month period.


Eligibility criteria:
inclusion criteria: * age from 40 to 75 years * patients with primary venous insufficiency * patients with venous ulcers with area larger than 2 cm2, who have received soc treatment in the previous three months. * ulcers with negative bacterial cultures or with polymicrobial flora. exclusion criteria: * patients with decompensated heart failure. * patients with lower limb edema of nonvenous etiology. * patients with diagnosis of diabetes mellitus. * patients with body mass index (bmi) ≤ 18.5 or \> 40.

Keywords: venous ulcer cell therapy
clarithromycin triple therapy plus bismuth for helicobacter pylori first-line treatment

Conditions: Helicobacter Pylori Infection

Summary: standard triple therapy including a proton pump inhibitor (ppi) and clarithromycin with either amoxicillin or metronidazole are no longer recommended as empirical ﬁrst-line therapy to treat helicobacter pylori infection because of high antibiotic resistance. it is unknown whether the addition of bismuth overcome antibiotic resistance. this study is designed to evaluate the efficacy and safety of the addition of bismuth to standard triple therapy for h. pylori first-line eradication.


Eligibility criteria:
inclusion criteria: * participants with non-ulcer functional dyspepsia or scarred peptic ulcer disease * ability and willingness to participate in the study and to sign and give informed consent * confirmed h. pylori infection exclusion criteria: * previous h. pylori eradication therapy * less than 18 years old * with history of h. pylori infection treatment * with previous gastric surgery * major systemic diseases * pregnancy or lactation * allergy to any of the study drugs * administration of antibiotics, bismuth, antisecretory drugs in 8 weeks prior to inclusion

Keywords: helicobacter pylori clarithromycin amoxicillin metronidazole eradication
flipped classroom in episiotomy education

Conditions: Flipped Classroom; Episiotomy

Summary: this study aims to evaluate the effect of using inverted classroom design on students' knowledge, skills and anxiety levels in teaching episiotomy application and repair, one of the interventions frequently used in labour.

the flipped classroom is a new and popular teaching model in which lessons traditionally conducted in the classroom become homework or homework responsibilities and lessons that would normally constitute homework become classroom lessons. in the flipped classroom, students become responsible for their own learning process and need to manage their own pace of learning, while the teacher helps the students instead of simply imparting information. while flipped classrooms are seen to offer many positive educational outcomes, they also have some limitations. in the flipped model, student learning achievement and satisfaction can be increased and it is considered to be more economical than traditional teaching. the literature shows that the flipped teaching model requires both opportunities and challenges. within the scope of the study, in order to evaluate the effect of using inverted classroom design in teaching episiotomy application and repair on students' knowledge, skills and anxiety levels, midwifery students taking normal birth and postnatal period courses will be divided into two groups, one group in the form of traditional teaching and one group in the form of inverted classroom design during the application of episiotomy teaching. the study data will be collected through student identification form, state anxiety inventory, episiotomy information form and episiotomy skill evaluation form. the data obtained from the study will be analysed with spss programme. it is thought that the study will make an important contribution to the literature in terms of evaluating the effect of the inverted classroom on teaching episiotomy repair.

Eligibility criteria:
inclusion criteria: 1. registered in the midwifery department, 2. participating in the normal birth and postpartum period course during the study period and 3. those who agreed to participate in the study exclusion criteria: 1. those who do not attend the normal birth and postpartum term course twice or more during the semester, 2. those who have taken this course before and have experience in episiotomy skills.

Keywords: flipped classroom midwifery episiotomy anxiety student
comparison of new suture anchor technique for bony mallet injury versus conservative treatment

Conditions: Finger Injuries; Finger Fracture; Finger Mallet

Summary: this study aims to compare conservative treatment versus a new suture anchor technique for bony mallet finger in 29 patients.

this study aims to compare conservative treatment versus a new suture anchor technique for bony mallet finger in 29 patients who presented to investigators' clinic between 2013 and 2015. patients were randomly assigned to conservative or surgical treatment groups. patients in the conservative group were followed with immobilization with aluminum splint and physical therapy. patients in the surgical group were treated with investigators' new surgical suture anchor technique and then received physical therapy. the patients were followed for 12 months. primary study outcomes were extension deficit, days to return to work and dip flexion.

Eligibility criteria:
inclusion criteria: * wehbe schneider type 1 - 2 and type a - b fractures * ability to provide closed reduction * patients' voluntariness exclusion criteria: * wehbe schneider type c and type 3 fractures

Keywords: bony mallet injury anchor suture conservative treatment dip joint
placental volume analysis during pregnanay

Conditions: Placenta Diseases

Summary: placenta grows with advancing gestational age amonitoring of placental growth is important in pregnancy evaluation

assessment of placental size is very important in evaluating the pregnancy placenta is one of the most important organs that control pregnancy outcome

Eligibility criteria:
inclusion criteria: * pregnant ladies between 20 - 40 years old * ladies pregnant from 14 weeks till term exclusion criteria: * pregnant ladies in first trimester
comparison of the hemostatic patch to fibrin sealant (tachosil®) in subjects undergoing hepatic surgery

Conditions: Liver Disease

Summary: the objective of this study is to evaluate the safety and effectiveness of covidien's hemostatic patch to control bleeding during hepatic surgery. the performance of the hemostatic patch will be compared to control as an adjunct to conventional hemostatic techniques.


Eligibility criteria:
major inclusion criteria: * scheduled for non-emergent, hepatic surgery * presence of an appropriate target bleeding site (tbs) as defined by the protocol major exclusion criteria: * subject will be undergoing a laparoscopic hepatic procedure where the hemostatic patch will be delivered and applied through a trocar * in subjects with documented history of cirrhosis, subject has uncorrected platelet count \<60,000 per mm³ as determined by laboratory tests performed immediately prior to surgery * subject has severe coagulopathy defined as inr \> 2.0 * subject has total bilirubin \>2.5mg/dl * subject has an active local infection at the target bleeding site * study procedure involves a liver transplant recipient

Keywords: hepatic topical hemostat
effect of statins on crohn's disease

Conditions: Crohn's Ileocolitis; Crohn Disease

Summary: the goal of this clinical trial is to learn if statins work to prevent strictures in adults with crohn's disease. the main question it aims to answer is: * can statins reduce the formation of strictures in participants with stricturing crohn's disease? researchers will compare statins to a placebo (a look-a-like substance that contains no drug) to see if statins work to prevent strictures from forming. participants will: * take statins or a placebo every day for 6-12 months * visit the clinic for lab tests twice after starting either statins or placebo * complete questionnaires about symptoms and medications * respond to monthly check-ins (via phone call) during participation

strictures are a formidable complication of crohn's disease (cd), with more than half of patients experiencing clinically significant bowel obstructions. stricturing cd is a primary driver of morbidity and hospital admissions and is frequently associated with treatment failures. moreover, it is estimated that nearly 50% of patients with cd will undergo bowel resection surgery within ten years of diagnosis, highlighting the severity and persistence of this issue for patients as well as the healthcare system. by modulating inflammatory and fibrotic pathways, the investigators posit that statins reduce primary stricture development and also recurrence after stricture resection. the investigators will assess the impact of statin therapy on early stricture recurrence in a pilot, randomized controlled clinical trial in patients undergoing stricture resection, evaluating both clinical outcomes and detailed immune, microbiome, and metabolic profiling. through this effort, the investigators will determine if statins reduce clinical and biological signs of stricture recurrence in the short term.

Eligibility criteria:
inclusion criteria: 1. established diagnosis of stricturing crohn's disease 2. scheduled for surgical resection of terminal ileum strictures at either * stanford university, or * dr. phillip fleshner's colorectal surgery practice in los angeles exclusion criteria: 1. pregnant, nursing, or planning to become pregnant in the next 6-12 months 2. severe renal dysfunction (stage 5 chronic kidney disease (ckd), end-stage renal disease (esrd)) 3. known clinical allergy or prior adverse reaction to statin therapy (e.g., rhabdomyolysis) 4. current use of cyclosporine 5. current use of statin therapy prior to study initiation 6. clinical diagnosis of active liver disease (beyond metabolic dysfunction-associated steatotic liver disease (masld)) with unexplained persistent elevations in hepatic transaminase levels 7. current use of any of the following medications, without explicit clearance from a treating physician to enroll in the study: * antifungals (e.g., ketoconazole, itraconazole, voriconazole) * fibrate drugs * macrolide antibiotics (e.g., erythromycin, clarithromycin) * protease inhibitors (e.g., ritonavir, lopinavir) * calcium channel blockers (e.g., verapamil, diltiazem) * amiodarone * warfarin * colchicine
clinical and radiographic evaluation of alkasite restorative material versus glass ionomer cement

Conditions: Tooth Decay

Summary: to evaluate the clinical and radiographic performance of alkasite restorative material versus glass ionomer in restoration of primary molars.

restorations replacements are mostly caused by the existence of caries lesions surrounding the restorations, which are commonly referred to as secondary caries . secondary or recurrent caries is characterized as "lesions that occur at the edges of previously placed dental restorations" or "caries that develop in association with dental restorations or sealants" (cars).proper seal at the tooth surface restoration interface is essential . that's why the most frequently material used is (gic) with the advantage of chemical adhesion to tooth structure, superior esthetics, and long-term fluoride release providing cariostatic effect, but it has the disadvantage of slow setting rate, low fracture toughness, susceptibility to moisture contamination, dehydration during initial phase of setting, and poor wear resistance. resin modified glass ionomer and composite have always been the preferred material for restoration although several modifications have been made recently to improve its properties, cent ion n is one of the recent ones. cent ion n is a tooth-colored basic filling material for direct restoration. it belongs to the material of alka sites, with high flexural strength. it also has calcium and fluoride releasing properties comparable to conventional gic, besides it is quick and easy to use.

Eligibility criteria:
inclusion criteria: * 1. children having carious primary molars without pulp exposure and normal radiograph. 2. children between age 5 and 7 years. 3. both male and female are included. 4. cooperative children. exclusion criteria: * 1. patients with systemic diseases. 2. parent refuse to participate.

Keywords: alkasite restorative material cention n gic primary molars
taiwan diabetes registry

Conditions: Diabetes Mellitus

Summary: to investigate the risk factors, life style and treatments of the microvascular disease，macrovascular disease and neuropathy in patients with diabetes.

at the first year (2015), the patients ever enrolled into the quality control study by taiwan association of diabetes educators in 2006 and 2011 will be recruited, and their relevant clinical data will be regularly registered yearly until 2030. in addition, it is planned that type 1 diabetic patients will be enrolled, and their clinical data will be regularly recorded yearly until 2030. also, newly diagnosed type 2 diabetic patients will be recruited, and their clinical data will be regularly entered to the diabetes web-based system yearly until 2030. we will also include pregnant patients with diabetes since 2023, and their data will be monitored and followed until 2030. finally, we will also include pregnant patients with diabetes since 2023, and their data will be monitored and followed until 2030.

Eligibility criteria:
inclusion criteria: * diagnosis of diabetes mellitus exclusion criteria: * patients who do not have diabetes mellitus * participating in an interventional trial requiring informed consent